Ruminative Thinking Styles Differentially Relate to Posttraumatic Stress Versus Growth Following Trauma Exposure

Mertens, Laura
Tamm, Gerly
Hoorelbeke, Kristof

Department of Experimental Clinical and Health Psychology, Ghent University

Rachel Wamser served as action editor.

The data supporting the findings of this study are available from the corresponding authors upon request. This study was conducted in accordance with the ethical standards of the ethical committee of the University of Ghent. Ethical approval was obtained from the local ethical committee at Ghent University. Informed consent was obtained from all individual participants included in the study. No material from other sources was used in this study.

The authors have no conflicts of interest to declare. This work was supported by a fellowship of the Research Foundation Flanders (Fonds voor Wetenschappelijk Onderzoek - Vlaanderen; 12J9722N) and a research grant of Ghent University (Bijzonder OnderzoeksFonds UGent; BOF/STA/202109/049) awarded to Kristof Hoorelbeke.

Laura Mertens played a supporting role in investigation and an equal role in conceptualization, methodology, writing–original draft, and writing–review and editing. Gerly Tamm played a lead role in investigation and a supporting role in conceptualization, methodology, and writing–review and editing. Kristof Hoorelbeke played a lead role in formal analysis, funding acquisition, methodology, project administration, and supervision and an equal role in conceptualization, writing–original draft, and writing–review and editing.

Laura Mertens, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Gent, Belgium [email protected]

Received December 5, 2024

revised May 7, 2025

Accepted May 8, 2025

Psychological Trauma: Theory, Research, Practice, & Policy Publish Ahead of Print, June 16, 2025. | DOI: 10.1037/tra0001969

Objective: Posttraumatic stress disorder (PTSD) is a debilitating disorder, with a lifetime prevalence of 3.9%. Recent findings suggest that ruminative thinking may play a crucial role in PTSD symptom development. Posttraumatic growth—positive psychological change following adversity—has also been linked to forms of rumination. The goal of this study was to examine the unique interrelations among different ruminative thinking styles, metacognitive beliefs, effortful control, and posttraumatic outcomes through network analysis. Method: Cross-sectional data were collected from two population-representative samples via Academic Prolific, consisting of individuals meeting Criterion A for PTSD (Study 1: N = 361; Study 2: N = 354). Variables included intrusive, deliberate, depressive rumination, positive and negative metacognitive beliefs, need for control, effortful control, posttraumatic growth, and symptom severity. Network analysis was used to model the interrelations among these variables. Results: The models suggest a central role of depressive rumination, deliberate rumination, and negative beliefs about rumination. The relationship between deliberate rumination and posttraumatic growth was the strongest included in the model. Effortful control was negatively associated with depressive rumination, which could serve as a protective factor. Last, metacognitions also seemed to play an important role, particularly negative beliefs about rumination. Conclusions: Different ruminative thinking styles were uniquely linked to PTSD symptomatology. Whereas each style of rumination was linked to increased PTSD symptom severity, deliberate rumination also showed strong associations with posttraumatic growth, suggesting the more adaptive nature of this thinking style. The obtained models elucidate the complex mechanism behind the development of PTSD, and growth, providing insights for future studies.